COVID-19 production animal FAQs for vets

Last updated: 8 April 2020

This page contains frequently asked questions relating to COVID-19 for equine and companion animal veterinarians. It will be updated as the situation progresses. Check out our COVID-19 page for veterinarians for more information.

The spread of COVID-19 and the publicity around it may be a cause of serious concern for some. If you would like professional support with this (or any other issue), free and confidential counselling is available to all veterinarians through Vitae.

Important: Your personal safety, and that of your colleagues and staff, comes first and we don’t expect you to put yourself at serious risk. Nothing on this page should be taken to suggest that.

I've been asked to do lepto vaccinations in tandem with TB testing, should I?
We can't source PPE, what can we do?
Do I have get written consent in light of COVID-19?
How can I use telemedicine in this situation?
What about referrals?
General advice for managing client contact at alert levels 3 and 4
How do I manage Production Animal calls at levels 3 and 4?
What if one of our clients is self-isolating and their animal is unwell?
I am starting or midway through a production animal program (embryo transfer and artificial breeding, internal teat sealant in cattle, pregnancy scanning of sheep programs etc). Should I continue?
Do veterinary clinics provide essential services?
What if our practice has to close or reduce services?
General guidance on acting in situations where you may need to act outside the Code of Professional Conduct and our other standards

I've been asked to do lepto vaccinations in tandem with TB testing, should I?

We've heard reports of requests to do lepto vaccinations at the same time as TB testing due to COVID-19 and that options discussed include the farmer getting the cows in again in a few weeks to do the lepto or an authorisation for the farmer to do the lepto vaccination as a one off (with appropriate guidance and distancing).

Veterinarians should consider:

Would vaccinating these animals be an essential service? The answer may be time-related in that it could be deferred if the lockdown only lasts 4 weeks but an extended delay might impact on the vaccination programme.
What are the risks associated with undertaking these vaccinations in this situation and can they be appropriately managed (it may be convenient to combine the 2 processes but thought must be given to all the risks and the impact on both human and animal safety).
Veterinarians are not obliged to authorise a veterinary medicine.
Veterinarians have a discretion to authorise lepto vaccinations for the farm staff to administer if, in the veterinarian's opinion, they would be administered competently and the veterinarian is comfortable authorising in the current circumstances.

We can’t source PPE, what can we do?

We’re aware that many veterinary clinics are finding it hard to source appropriate PPE at the moment. The issue has been raised with the authorities and suppliers and we will continue to do what we can to source PPE for the profession.

In the meantime, rationing and appropriate re-use may help. Also, this article by Dr Scott Weese on surgical mask shortages has some useful thinking and ideas.

Do I have to get written consent from clients in light of COVID-19?

Obtaining client consent is a requirement under the Code of Professional Conduct. However, we understand that veterinarians will need to put in place measures to reduce contact between staff and clients and that this may change how client consent is gained.

The Code allows for verbal consent to be given so long as it is documented in the clinical history. If you gain verbal consent from a client, it is important that discussions about the proposed treatment are recorded in the clinical history. Another option is to email the client a copy of the consent form along with any supporting information you think is important. The client can then reply by email acknowledging they have received the information or sign the document and email it back which may be a preferred step where there is not an established relationship and so may apply to new clients. An electronic copy could then be attached to the clinical history.

Regardless of whether verbal consent, an electronic, or a physical form is used, it is important that clients are given information about proposed treatment or course of action in a way that they can understand.

How can I use telemedicine in this situation?

Veterinary Telemedicine (VTM) can be used and is a useful tool to help limit the risk of spread of COVID-19. It should be used at alert levels 3 and 4 to triage all cases.

We expect veterinarians to use their professional judgment to decide whether using VTM is appropriate in particular circumstances.

The Code of Professional Conduct allows for authorising (prescribing) restricted veterinary medicines by VTM where the veterinarian:

Has seen the animal(s) recently enough to have enough personal knowledge of their condition and health status so they can propose a particular course of treatment.
Is satisfied that a physical examination would not add critical information about the management of the case.

At levels 3 and 4, veterinarians can also use VTM to authorise medicines where they can reasonably judge it safe to do so even if they haven’t seen the animal recently. Ideally, this should be done using patient histories and/or recent visits to the premises.

The onus here will be on the veterinarian gathering a sufficient history and description of symptoms, carefully exploring possible differentials, establishing a suitable treatment plan with the clients consent and ensuring close follow up to promptly modify their approach as the condition responds or progresses. It will be vital that the veterinarian to record their findings to enable appropriate continuity of care.

While this departs from the clear standard set in the Code, we consider that it is justified in this extreme situation to protect veterinarians, their staff, and the wider public. Risk assessment and professional judgment by the veterinarian in each case is still vital.

See our Statement on Veterinary Medicines and Authorising at COVID-19 alert levels 3 and 4 for more information.

What about referrals?

Some specialists and referral centres will still operate at levels 3 and 4. Please bear in mind they are likely to be especially busy and only providing essential services. At levels 3 and 4, we need to minimise domestic travel and veterinarians should consider the impact of inter-region travel. In some cases balancing animal welfare against the need to stop the spread of COVID-19 may mean that local care should be given even if this risks a less optimal outcome for the animal.

Ways to navigate inter-regional travel issues may include a telemedicine referral consultation with a specialist or local colleague that is prepared to accept referrals. This may assist the veterinarian to treat the problem themselves as long as welfare needs of the patient are met.

Where the veterinarian is unable to meet the patient’s needs then referral to a specialist or colleague who is prepared to accept referrals in another region may be appropriate.

See our Guidance for veterinarians on referral, supersession and second opinions during the COVID-19 pandemic for more information.

General advice for managing client contact at alert levels 3 and 4

There are some general principles that should be adopted across the veterinary sector:

All unnecessary client contact must be stopped. You should:
•   Clarify client’s medical status with regard to Covid-19
•   Obtain histories over the phone
•   Use technology to triage and consult wherever possible
•   Consider remote authorising in line with VCNZ guidance
•   Obtain payment over the phone
•   Ensure contact-free collection of medication is in place, with a specific, secure collection time and place organised in advance
•   Courier medication if appropriate following Courier guidance and, where applicable, following VCNZ controlled drugs guidance

All staff that can work from home should work from home. This includes:
•   Administrative staff
•   Vets and nurses carrying out triage and remote consultations from home, referring to skeleton staff at a physical premises only if absolutely necessary

Follow all hand hygiene and biosecurity measures and thoroughly clean all equipment after each use

Follow strict social distancing measures between clients at all times and be prepared to refuse to continue if animal owners do not follow the official advice.

Continue to deliver emergency treatment, including euthanasia, of wildlife in accordance with your normal practice, as long as it can be done safety under social distancing rules.
Consider how you can best manage risks to avoid injuries to staff. A high risk for the general population now is the need to attend a healthcare facility, that no doubt is busy responding to the COVID-19 pandemic and expose themselves to infection.

How do I manage Production Animal calls at levels 3 and 4?

Maintain a physical distance of 2m at all times

In cases where clients are self-isolating or confirmed to have Covid-19 a second member of practice staff should attend to ensure your health and safety. Contact with the client should be by telephone only

Cleanse all surfaces in your car on leaving the property

Do not enter the living quarters or farmhouse for any reason

Follow the most up to date government advice re statutory surveillance and bovine TB testing

What if one of our clients is self-isolating and their animal is unwell?

You should only see the animal in person in an emergency or where treatment is urgent to prevent a future emergency. You will therefore need to decide whether the animal needs to be seen now, or whether treatment can be delayed. If, after triaging the animal, you still feel it is necessary to see them, consider whether it could be brought to you (or you go to it) without putting your own, or someone else’s, health at unnecessary risk.

For example, ask whether another person can bring the animal to the practice, or another appropriate location, on the owner’s behalf.

The current guidance from the World Health Organisation is that there is no evidence that companion animals can be infected with the new coronavirus. However, if you do decide to see the animal in person, normal biosecurity measures, as well as additional government guidance on hand washing, should be observed.

Consider the extent to which you can assist remotely – this may include giving advice via remote means as to how to manage the animal’s condition at home. It may also include remote authorising of restricted veterinary medicines where there is no other option that would be a suitable alternative, and where you are satisfied the risk is outweighed by the benefit. In this scenario, document your rationale for your decision making to ensure you can justify your actions if asked to do so.

You should ensure that there is a plan in place for the animal to be physically checked as soon as possible especially in the case of adverse reactions. However, please remember that in order to comply with current government guidance, face-to-face services should be kept to an absolute minimum and only occur when necessary.

There may be instances where, in order to ensure your own safety, an animal needs to be taken away from its owners to undergo treatment, or euthanasia, for welfare reasons. This is likely to be particularly upsetting as most owners will want to be with their animal when they are put to sleep. As such, you may wish to consider whether you can direct them to an appropriate source of support, for example a bereavement or counselling service.

I am starting or midway through a production animal program (embryo transfer and artificial breeding, internal teat sealant in cattle, pregnancy scanning of sheep programs etc). Should I continue?

Veterinarians must weigh up the risks involved when deciding whether to proceed with animal healthcare treatment. This means balancing the potential harm to the animal against the need to protect staff and stop the spread of COVID-19.

The questions that need to be considered include:

Am I able to prevent or manage the risks of exposure of my staff and myself to COVID19?
Are there implications to animal welfare and animal health if I delay treatment?
Are there implications for food production if I delay treatment?
Is immediate action necessary in the interests of animal welfare, animal health and well-being, biosecurity and surveillance, and food safety?

If you answer yes to these questions, then it would be considered justifiable to proceed with the treatment.

Do veterinary clinics provide essential services?

Veterinary services are an essential service and can continue to operate at levels 3 and 4 as long as they operate in a way that limits or eliminates the risk of spreading COVID-19.

If a veterinary business is going to continue to operate, you must read this information from MPI and take action. If there are 5 or less workers on site at any one time and there is a plan to keep people at least 2 metres apart, registration is not necessary. If these criteria are not met, the business must register with MPI. There is a form available at the above link.

There is more information available on the MPI web page and questions about registering can be directed to MPI at 0800 00 83 33 or [email protected].

Our advice is that veterinarians should consider what aspects of their work are essential and what can be postponed to help minimise risk and spread of the disease.

Internationally, there is widespread agreement that veterinary services are essential for public health, food production and dealing with emergencies. We believe that the same applies in New Zealand.

Veterinarians will need to think carefully about what aspects of their work are essential. Examples of essential work could be:

Production animal services needed to ensure that food production continues and is safe and humane.
Veterinary verification at food processing facilities.
Companion animal services that cannot be postponed or cancelled without risking serious pain or suffering to the animal.
Veterinary emergency services.

Services like health checks and routine vaccinations are unlikely to be essential at least in the immediate future.

Even with non-essential services shut down, we see nothing stopping veterinarians offering telemedicine (digital consultations and advice).

What if our practice has to close or reduce services?

It is possible that some practices may need to close or reduce services, for example, if a staff member tests positive for the virus and needs to self-isolate.

If this happens, the practice should:

Notify their clients as soon as possible. Give them as much information as possible about how long this will be in effect for and, if possible, direct them to other places they can find help. That could be a neighbouring practice (ideally talk to them first) or our online register of practices.
Make sure the phones are diverted and the answerphone is updated.
Consider putting a notice on the practice’s website.
If the practice operates its own emergency and afterhours service, try to find alternative cover for this. If an emergency and/or afterhours centre is used, double-check that this is still able to operate.

If a veterinarian in this situation is contacted by a client about an animal that the veterinarian decides needs urgent veterinary attention, they should decide whether they can safely examine and treat the animal (for example having the animal dropped at the practice and admitting it for inpatient care). If that isn’t possible, consider using VTM or referring to another veterinarian.

Where services have to be reduced, the focus should be on triage and prioritising urgent cases. VTM may be particularly helpful.

General guidance on acting in situations where you may need to act outside the Code of Professional Conduct and our other standards

Think about:

Is this an emergency (is there a need for immediate or early veterinary treatment to save life or relieve unreasonable or unnecessary pain or distress)?
Can the animal be referred to someone better able to deal with the situation?
Discussing the situation with the client and getting their views and informed consent.
What are the risks and are there ways to reduce them (e.g. regular and frequent follow up)?
Could your actions be justified to your peers?

We highly recommend making a detailed record of your decision making in these circumstances.

Looking after yourself and your staff will probably mean departing from best practice. We recognise this and will take the broader situation into account if any concerns are raised with us.

Definitions:

Teletriage: Patient triage by phone or use of technology prior to diagnosis or treatment

Veterinary Telemedicine (VTM): veterinary telemedicine is the use of technology such as phone, email, or video conferencing to provide veterinary care including diagnosis and treatment without being physically present with the animal or owner.